Modified Liquid-Based Cytology Technique for Immunocytochemistry in Effusion Specimen

Abstract

Objective: Immunocytochemistry (ICC) of serous effusion is an important tool for the diagnosis of benign and<br />malignant cells. Our aim was to develop a modified liquid-based cytological technique for ICC (i.e., a modified LBC).<br />Methods: Serous effusions of 110 cases were collected for cytological examination: 50 were negative for malignancy<br />albeit benign mesothelium was found, and 60 were confirmed metastatic adenocarcinoma according to the modified LBC<br />preparation. The latter were stained for EMA, Ber-EP4, Calretinin, and p63 then interpreted by both a cytotechnologist<br />and a pathologist. A comparative analysis of the diagnostic results was conducted. Results: The results of the metastatic<br />adenocarcinoma were 100% (60/60) positive for EMA and 91.7% (55/60) positive for Ber-Ep4 but negative for calretinin<br />and p63. Cases negative for malignancy were 100% (50/50) positive for calretinin but negative for carcinoma markers.<br />The difference between ‘positive for metastatic adenocarcinoma' and ‘negative for malignancy' in ICC was statistically<br />significant (p < 0.001). Conclusion: The current study demonstrated that a panel marker, comprising EMA, Ber-EP4,<br />and calretinin can be used for differentiating between cases of metastatic adenocarcinoma and benign mesothelium.<br />The serous effusion specimen collected by the modified LBC technique is an effective preparation method for ICC.